The aim of the study is to investigate the quality of prehospital emergency care in acute coronary syndromes, when paramedics are supported telemedically by an EMS physician.
Six ambulances from five different Emergency Medical Service (EMS) districts are equipped with a portable telemedicine system. In cases of suspected acute coronary syndrome (including STEMI), the paramedics can use this system to contact a so called "tele-EMS physician" after consent of the patient is obtained. The tele-EMS physician has an audio-connection to the EMS team and receives vital parameters (e.g., ECG, pulse oximetry, non-invasive blood pressure) in real-time. Also 12-lead-ECGs can transmitted to the tele-EMS physician. The transmission of still pictures - taken with a smartphone - and video streaming from the inside of the ambulance can be carried out, if meaningful. The tele-EMS physician supports the EMS team in obtaining all relevant medical history, ECG diagnosis, general diagnosis and can delegate the application of medications. This can be carried out to bridge the time to the arrival of an EMS physician or in less severe cases without an EMS physician on-scene. The quality of prehospital care and the possible influences on the initial inhospital phase should be investigated and compared with regular EMS.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
39
Teleconsultation of an EMS physician to support the paramedics in acute coronary syndromes
University Hospital Aachen
Aachen, Germany
Quality of prehospital care
Analysis of the quality of the prehospital care on the basis of published guidelines for ACS / STEMI
Time frame: average 1 hour
Inhospital time intervals in STEMI
contact to balloon time, arrival to balloon time
Time frame: up to 12 hours
Rate of secondary transfer for PCI
Rate of secondary transfer to a different facility for PCI
Time frame: up to 7 days
Troponin-Level
Severity of infarction measured with level of Troponin
Time frame: 24 hours
Conducted procedures and medications (paramedics)
Amount of guidelines based procedures and medications carried out by paramedics prior to the contact with a physician.
Time frame: average 1 hour
prehospital time intervals
on-scene time, contact (EMS) to hospital arrival time, transport time
Time frame: average 1 hour
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